A late adolescent patient presented with a Class III malocclusion on a skeletal Class III base, complicated by severe upper arch and moderate lower arch crowding, reverse overjet, anterior and bilateral posterior crossbites with displacement, proclined upper incisors, retroclined lower incisors, distally tipped lower canines and non-coincident centrelines. Treatment was undertaken on an extraction basis by employing the use of an upper removable appliance with Z-springs and posterior bite blocks to correct the anterior crossbite, quad helix and jockey arch for arch expansion, and pre-adjusted edgewise fixed appliance to level and align, space closure and achieve a mutually protective functional occlusion. This paper discussed the rational and evidences behind the treatment employed.

Supernumerary teeth have a genetic predispositionwith a predilection for males. This article reports anuncommon radiological finding in a non-syndromicsibling pair who presented with supernumerary teethof different morphologies on opposite and differentregions of the dental arches. A 14-year-old Chinesemale presented with a conical supernumerary palatallyplaced between the upper right central and lateralincisors. His older brother had unerupted bilateralsupplemental supernumerary teeth between the rootsof the lower second premolars and first permanentmolars. Trends of the phenotypic presentation offamilial non-syndromic supernumerary cases arediscussed. Familial supernumerary teeth have beensuggested to be due to autosomal dominance orrecessive traits. Variation in the numeral, spatial andmorphological phenotypic expressions suggests amultifactorial model of multiple genetic, epigeneticand environmental influences. Clinicians need to bemindful of the possible phenotypic variations that maypresent when treating cases with family history ofdental anomalies.

The study aimed to assess patient satisfaction withtheir orthodontic treatment outcome and type of casesaccepted for orthodontic treatment at the Faculty ofDentistry, University of Malaya (UM) and to audit thequality of treatment outcome. The standard set were100% patient should be satisfied with their treatmentoutcome and less than 5% of the proportion of casesshould fall in the “worse/no different’ category with amean reduction of Peer Assessment Rating (PAR) scorebeing greater than 70%. Records of cases that hadcompleted orthodontic treatment were traced. Surveyforms were sent to 150 patients that had met theinclusion and exclusion criteria. Their intact studymodels were assessed for the Index of OrthodonticTreatment Need (IOTN) and PAR. 21.3% responded tothe survey, of which 59.4% had treatment involvingfixed appliances and 37.6% had either removable orfunctional appliances or retainers. 93.8% respondentswere satisfied with their dental alignment and 87.5%with the overall treatment results. For the dental healthcomponent of the IOTN, 63.3% had ‘definite need’ and21.1% had ‘borderline need’ for treatment. For theaesthetic component of the IOTN, 24.2% had ‘definiteneed’ and 32.0% had‘borderline need’ for treatment.For the PAR, 8.0% had an outcome of “worst/nodifferent”. The mean PAR reduction score was 75.3%.In conclusion, although majority were satisfied withtheir treatment results, there is still a need to improveon the standard of care to address the issues of theminority who were not satisfied with the treatmentoutcome.